Robot-assisted microsurgery: a single-center experience of 100 cases

Area of Science:

• Microsurgery
• Robotic Surgery
• Surgical Technology

Background:

• Robot-assisted microsurgery (RAMS) represents an advancement in microsurgical techniques.
• The Symani Surgical System offers tremor elimination, motion scaling, and improved ergonomics.
• Recent CE and FDA approvals highlight the system's growing acceptance.

Purpose of the Study:

• To report on the first 100 consecutive cases of RAMS at a high-volume academic center.
• To assess the clinical application and efficacy of RAMS.
• To evaluate the safety profile and outcomes of RAMS in diverse microsurgical procedures.

Main Methods:

• A prospective database collected data on 100 consecutive RAMS cases between February 2023 and April 2024.
• Data included patient demographics, surgical details, and outcomes.
• Surgeons underwent a 12-hour training program prior to system use.

Main Results:

• RAMS was performed in 100 patients (mean age 54 years, 66% male), primarily for free flaps (73%), nerve surgery (20%), and lymphovenous anastomoses (LVA) (6%).
• 159 anastomoses were performed with a 12% major complication rate; 2.7% of free flaps were lost completely, and 1.4% partially.
• LVAs showed significantly longer times per stitch (p<0.01). Conversion rate to conventional techniques was 3%.

Conclusions:

• RAMS is a feasible and viable alternative to traditional microsurgery in a high-volume setting.
• The system demonstrates a commendable safety profile, with complication rates comparable to existing literature.
• Challenges include longer anastomosis times and higher costs, but overall efficacy is affirmed.